Under the radar: Angola plays down yellow fever crisis

Angola is facing a public health emergency. Its under-funded hospitals, inadequate at the best of times, have been overwhelmed by a series of disease outbreaks, and the government has been forced to turn to private business and well-wishers for help.

No one knows the true mortality figures – a product of both Angola’s poor data-keeping and the government’s preference to bury bad news. But there have been media reports of 50 people (or 25 children) dying daily from malaria, yellow fever, dengue and typhoid.

“Angola is going through a very serious economic crisis as it’s heavily reliant on oil,” said Vibeke Skauerud, from Norwegian Church Aid. “Revenues have fallen by more than half. Hospitals are running out of basic supplies. That, coupled with bad governance, has led to the deep crisis that we now see.”

An outbreak of mosquito-transmitted yellow fever has killed 168 people since it emerged in Luanda’s poor neighbourhood of Viana in December – with suspected cases now reported in 16 out of 18 provinces.

Health officials launched a vaccination programme in Luanda in February, but the World Health Organization says the campaign has been hit by a number of constraints. “These included availability of vaccines, inadequate number of vaccination teams and limited funds to cover operational activities," a WHO briefing said.

The immunisation campaign has so far reached six out of a targeted 12 municipalities in Luanda.

Not under control

Cases seem to be accelerating across the provinces, with reports of yellow fever reaching the northern border with the Democratic Republic of the Congo, WHO said.

The UN agency has declared the outbreak a “grade two emergency” on its three-point scale. Other grade two emergencies include the conflict in northeastern Nigeria, Cyclone Pam in Vanuatu last year, and floods in Myanmar, Mozambique and Malawi that displaced tens of thousands of people.

“Of particular concern is the cross-border and international spread risk of the disease, which has already been documented, with cases recently rumoured to have been exported to China, Kenya and the Democratic Republic of Congo,” WHO said in a 21 March bulletin.

At the end of February, the UN Resident Coordinator Pier Paolo Balladelli and the heads of UN agencies called a meeting with the Angolan Industrial Association to appeal for private sector donations and logistical help with the yellow fever crisis.

Angola expert Paula Roque of Oxford University said she had heard of Angolan doctors based in South Africa sending medical supplies back home to help ease the shortages in a country that is Africa’s second largest oil exporter, and until recently was a rising economic star on the continent.

“Civil servants haven’t been paid their salaries. Inflation has tripled food prices. Angola is going through a real financial crisis,” she told IRIN.

Oil accounts for 95 percent of government revenue. “Of course the oil price crash could be considered one of the reasons [for the crisis], but the huge corruption across the health sector is another one, and maybe the most important one,” said Alves da Rocha of the Centre for Studies and Scientific Investigation at the Catholic University of Angola.

A searing indictment of the health system and government spending priorities – titled The Morgue – was published on 24 March by rights activist Rafael Marques de Morais. It catalogues in scary detail how health workers lack even some of the most basic items, like gloves and masks. Not the best backdrop for an emerging crisis that has so far flown largely under the international radar.